Concerns over ACE inhibitor or ARB use to treat hypertension during COVID-19 remain unresolved. Although studies using more robust methodologies provided some clarity, sources of bias persist and it remains critical to quickly address this question. In this review, we discuss pernicious sources of bias using a causal model framework, including time-varying confounder, collider, information, and time-dependent bias, in the context of recently published studies. We discuss causal inference methodologies that can address these issues, including causal diagrams, time-to-event analyses, sensitivity analyses, and marginal structural modeling. We discuss effect modification and we propose a role for causal mediation analysis to estimate indirect effects via mediating factors, especially components of the renin--angiotensin system. Thorough knowledge of these sources of bias and the appropriate methodologies to address them is crucial when evaluating observational studies to inform patient management decisions regarding whether ACE inhibitors or ARBs are associated with greater risk from COVID-19.The upward trends in the prevalence and control of hypertension in Chinese adults have been described, but recent trends based on the most recent guidelines are unavailable. We examined recent trends in the prevalence, awareness, treatment and control of hypertension among Chinese adults from 1991 to 2015 based on the 2018 Chinese Guideline.
A total of 72?452 adults aged 20-79 years from the China Health and Nutrition Survey conducted between 1991 and 2015 were included in the study. Hypertension status and control rate were defined according to the 2018 Chinese Guideline. Age-standardized estimates were calculated based on the age distribution of the WHO standard population.
From 1991 to 2015, the crude/age-standardized hypertension prevalence (14.0/15.3 to 34.1/25.6%), awareness (29.4/24.2 to 43.8/27.2%), treatment (19.2/15.1 to 39.2/23.6%) and control rates (3.5/3.6 to 13.8/8.4%) increased (all P for trend &lt;0.001). The prevalence of hypertension increased at a greater rate in rural regions compare control of hypertension in Chinese adults.Estimated pulse wave velocity (ePWV) is emerging as a predictor of cardiovascular and all-cause mortality. Approximately one-third of all deaths are not related to the top nine causes of mortality as defined by the CDC. We examined the association of ePWV with residual-specific mortality in a large sample of US adults.
Data from the 1999-2006 National Health and Nutrition Examination Survey (NHANES) were used (n?=?13?909 adults between the ages of 18-85 years), with follow-up through 2011 (mean follow-up, 104 months). ePWV was calculated from a regression equation using age and mean blood pressure.
After adjusting for age, pulse pressure, race/ethnicity, blood lipids, glucose, C-reactive protein, eGFR, smoking, self-reported physical activity, history of hypertension and diabetes, for every 1?m/s increase in ePWV, there was a 17% increased risk of residual-specific mortality (hazard ratio?=?1.17, 95% CI?=?1.02-1.36; P?=?0.03). If using a previously recommended clinical cut-point of 10?m/s, those with an elevated ePWV had an increased risk of 57% (hazard ratio?=?1.57; 95% CI?=?0.98-2.50; P?=?0.06).
ePWV is associated with residual-specific mortality in a nationally representative sample of adults.
ePWV is associated with residual-specific mortality in a nationally representative sample of adults.Hypertension is the leading cause of cardiovascular disease and premature death. https://www.selleckchem.com/products/tecovirimat.html New methods for early detection of hypertension and its consequences can reduce complications arising from uncontrolled hypertension. Pulse-wave velocity (PWV), a measure of arterial stiffness, has been recognized as a valuable tool in assessing risk for cardiovascular complications, although its use in clinical practice is currently limited. Here we examine whether brachial--ankle PWV (baPWV) and femoral--ankle PWV (faPWV) are elevated in nonhypertensive volunteers, with and without a history of familial hypertension.
Volunteers were recruited and questioned as to their medical background and family history. Participants were divided into two groups based on history of familial hypertension and were measured for baPWV and faPWV. Carotid--femoral PWV was computed from these measurements.
A total of 82 healthy nonhypertensive volunteers (mean age 31.4?±?9.6) were recruited. Among the study cohort, 43.7% had a history of famik stratification, especially in persons with a history of familial hypertension.The purpose of the present study was to investigate the effects of serum triglyceride levels on the risk of new-onset hypertension in Japanese.
Five thousand nine hundred and thirty-three Japanese workers without hypertension at baseline, who participated in medical check-ups from 2006 to 2018, were followed retrospectively. The participants were divided into quartiles of casual serum triglyceride levels and were followed from the first to last visit of the study period. The outcome was development of hypertension. Risk estimates were computed using Cox's proportional hazards model.
During the follow-up period (average 6.7 years), 946 individuals developed hypertension. The crude incidence rates of hypertension (per 1000 person-years) increased with rising serum triglyceride levels 10.1 for quartile 1 (&lt;0.76?mmol/l), 19.6 for quartile 2 (0.76-1.17?mmol/l), 26.0 for quartile 3 (1.18-1.84?mmol/l), and 36.5 for quartile 4 (&gt;1.84?mmol/l) (P?&lt;?0.0001 for trend). These associations remained significant even after adjustment for other risk factors the multivariable-adjusted hazard ratio was 1.29 (1.01-1.66) for the second quartile, 1.27 (0.99-1.63) for the third quartile, and 1.39 (1.09-1.77) for the highest quartile compared with the lowest. There were comparable effects of serum triglyceride levels for incidence of hypertension between subgroups defined by sex, obesity, and diabetes (all P?&gt;?0.1 for interaction), whereas stronger associations were observed for participants under 40 years of age than for those aged 40 or above (P?=?0.002 for interaction).
Serum triglyceride levels were significantly associated with development of hypertension in a Japanese worksite population.
Serum triglyceride levels were significantly associated with development of hypertension in a Japanese worksite population.